Crib - the Sequel

Maggie is off of the IV as of yesterday and is back in a crib. She is maintaining her temperature well and is up to full feeds (43ml). The overnight nurse gave Maggie her first bottle, so she is now working on three feedings by mouth.

She is still immature, so her full sucking reflex isn't fully developed, so it takes her a long time to get started and by the time she gets going feeding she isn't able to take much because she gets worn out. Last night it took her 15 minutes to collect herself and start feeding, once she did get going she took 9ml by bottle.

The nurse today suggested we start occupational therapy, which will help Maggie's oral stimulation before nursing or bottle feeding. Maggie's nurse said baby's typically do well with this stimulation. The bigger she gets and the more developmentally mature she will get the better she will do at her feedings.

We did the technique today and she latched on much faster and was able to go a little longer. We are going to do this for her at each feeding, even if it's a gavage feeding.

Maggie will get her Hep B vaccine today and I was given information about RSV and a special vaccine Maggie will recieve throughout cold and flu season. It's a series of shots she will receive once a month from November through March to help her immune system fight off any type of respiritory infection caused by a common cold during the long cold and flu season.

We learned last night that we will need to do lots of hand washing and hand sanitizing this winter and be very conservative about taking her out of the house. The last thing we want is for her to end up back in the hospital. The fun part will be teaching our 17 mo. old Cece about germs. We'll see how that goes.

Four Weeks!

Maggie is 4 weeks old today (35 weeks 2 days corrected age) and weighs 4lbs 11oz - almost 5 whole pounds! Maggie's doctors are agressively increasing her feeds today so she will be off of the TPN by this evening, meaning no more IV. Woo hoo!

As her volumes rise to full feeds, the nurses will again be adding fortifier to her milk (which adds calories without adding volume) to help her grow. Within the next few days, we also anticipate the nurses/docs will start her on mouth feedings (bottle or breast).

They are also starting to wean her out of the isolette once more. Hopefully she'll be able to maintain her temperature better this time, especially since she's got more meat on her bones to keep her warm.

I asked her doctor today when we're looking at getting Maggie home and she seemed optimistic that we're looking at another two weeks. I'm so excited and hope these next two weeks fly by as fast as the last four have.   

Nursing resumes!

I was able to resume nursing with Maggie yesterday. Today's feedings went well and she took 15ml tonight at 8 p.m. She is still taking Lipids and TPN through IV until she's back up to full feeds. The doctors have OK'd an increase in feeding volume twice a day. She is currently at 20ml and will most likely increase again tomorrow. Maggie was at 37ml last Thursday, before the NEC scare. I hope that she'll be off the IV by the weekend and back to full feedings.

Maggie is still in the isolette and I'm sure that she'll be out of it soon enough. She's been maintaining a higher temperature and now that she's put on some extra weight (she actually is starting to look chubby if you can believe it) she'll stay warmer.

No other news to report. She continues to do what she needs to do - eat, sleep, snuggle, etc. It's hard to believe that she's already 4 weeks old tomorrow. The time sure has flown by.

Negative is Good!

Good news today. Maggie's final test results are negative for NEC. We are so very happy to hear that. Today at 2 p.m., Maggie's feeds resumed, starting with 5ml every 3 hours and slowly increasing in volume. As her feeds increase, they will decrease her TPN and lipids, just like when she was first born. Once her volume increases, we will be able to nurse again. I'm sure she'll be back on track by the end of the week.

No NEC is good NEC

Preliminary test results are negative for NEC, however the doctors are still taking every precaution necessary with Maggie. She has been recieving antibiotics this weekend and is back on TPN and lipids for nutrition. She is back in the isolette, too, since her temperature has been on the cool side since she moved to a crib last week.

Today, Maggie is doing great. Her tummy x-rays look good, her bowel sounds are normal and her abdomen is soft. Tomorrow, they will slowly resume her feeds and will come off the IV nutrition fully in a few days.

This is all good news to us. We are so happy the doctors and nurses are on top of everything with Maggie. Everyone seems optimistic that her final blood tests will come back negative for NEC.

Maggie's weight continues to climb, today she is 4lbs 4oz.

I'll be heading to the hospital in an hour to kangaroo with Maggie and look forward to tomorrow when her feeds resume.

Scary

After last night's bloody stool, the doctors did an X-Ray of Maggie's tummy this morning. The doctors were concerned with what they saw on the x-ray. She hasn't had another bloody stool since last night, but the doctors wanted to rule out the possibility of NEC - Necrotizing Eterocolitis - which would be a very serious problem with her bowels. One of the doctors said that Maggie shows no apparent signs of this since she has been tolerating her feeds well, been stooling well, etc. - but they are taking every precaution to make sure she is OK.

So, Maggie's feeds stopped today and she has an IV again to receive antibiotics and TPN. The doctors have to run a blood culture, we will have preliminary results from the test tomorrow morning and will have final results Sunday morning.

This was discouraging news to me today, since Maggie did such a great job nursing (14ml) and she has been making such great progress over the last three weeks. My visit this afternoon was cut short because they needed to start her IV immediately. I pray that she is OK.

Jeff went to the hospital tonight to kangaroo with Maggie. He didn't get to see her today, as he had to work. Hopefully, we'll have good news in the morning.

Please keep Maggie in your prayers this weekend.

First Bath

Tonight I learned how to give Maggie a bath. She is pretty tiny, so it was nice of the nurse to show me how best to clean her. I need to keep her wrapped up (so she stays warm) while I wash her face and hair, then I can put her in the mini tub and wash her. Pretty simple. Maggie seemed to enjoy her bath. She didn't fuss at all. I took a picture, which I'll have to upload tomorrow.


Tonight, Maggie had some blood in her stool, so the NNP came and checked her out. She has a fissure on her rectum (probably from all of the pooping she's doing), so it wasn't a major concern to the nurse. They will monitor her over the next day or so to make sure she is ok.


Maggie took 6ml tonight during her feeding and was very alert my entire visit. I arrived early for bathtime, then she wanted to visit before we nursed. She did a good job, but got tired quickly. I dressed her back up and we snuggled during her gavage. She was awake for a long time, so we talked and I sang to her. Then she fell asleep and I tucked her in and kissed her goodnight.


Tomorrow we start our passport to home curicculum, which is the next step on our path to bringing Maggie home. Jeff and I get to check off what we want to learn more about before we bring Maggie home. I'll learn more tomorrow about all of the things we need to know/do before Maggie comes home.